Individual provider Active NPI

Kristen Ann Walls, PHYSICIAN ASSISTANT

  • Physician Assistant
  • McKinney, TX
National Provider Identifier
1609313139
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11087 Issued in TX
Practice address
5220 W University Dr Ste 290
McKinney, TX 75071-7429
Phone
(469) 678-8322
Fax
(469) 678-8311
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11087 TX Primary
Physician Assistant 363A00000X TX

Addresses

Primary practice location

5220 W University Dr Ste 290
McKinney, TX 75071-7429

Mailing address

PO Box 3409
Pflugerville, TX 78691-3409
Phone (512) 202-3830

Other identifiers 1

IdentifierTypeStateIssuer
387287101MedicaidTX

Other names 1

  • Kristen Ann Venhuizen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719003262 TX Practitioner - Physician Assistant 6507134954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Provider Health PAGroup PAC ID 2264531276, 30 clinicians

Practice addresses (Care Compare)

5575 Warren Pkwy
Suite 206
Frisco, TX 75034-4066
Phone (469) 287-7089

Hospital & facility affiliations

  • Centric Home Health Home health agency, Sherman, TX, CCN 679721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA11087TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Provider Health PA CurrentSince Apr 3, 2018 Accepting new patients
Premier Provider Health PA CurrentSince Apr 3, 2018 Accepting new patients
Renovo Wound and Hyperbarics PLLC PastSince Sep 20, 2020 Accepting new patients
Premier Provider Health PA Past Accepting new patients
Han Pham Hulen MD PA Past Accepting new patients
Premier Provider Health Utah PLLC Past Accepting new patients

Locations

4316 James Casey St
Ste B-100
Austin, TX 78745
Phone (512) 444-4325

9301 N Central Expy
Ste 340
Dallas, TX 75231
Phone (214) 466-2828

251 Westpark Way
Ste 300
Euless, TX 76040
Phone (817) 848-5880

1300 W Rosedale St
Ste A
Fort Worth, TX 76104
Phone (817) 377-4011

5575 Warren Pkwy
Ste 206
Frisco, TX 75034
Phone (469) 287-7089

5220 W University Dr
Ste 290
McKinney, TX 75071
Phone (469) 678-8322

4001 W 15th St
Ste 100
Plano, TX 75093
Phone (214) 473-7570

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1609313139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3409",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786913409",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 W UNIVERSITY DR STE 290",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717429",
            "telephone_number": "469-678-8322",
            "fax_number": "469-678-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11087",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387287101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "VENHUIZEN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.